Patient Claims

The Patient Claims function submits the patient’s claim directly to Medicare on behalf of the patient. It operates in two modes:

1. Store and Forward

2. Real-Time

In Store and Forward mode, the claims are “batched” up and transmitted to the HIC at a later time when convenient. This is similar to the way in which Bulk Bill and DVA claiming works. At the time the invoice or receipt is generated, the patient claim content is created and stored in the Genie database. At some later time, e.g.the end of the day, all of the claims which have been created are batched up and transmitted to the HIC. In this mode, the Internet connection only needs to be available when the claims are transmitted.

In Real-Time mode, the patient claim is created and transmitted to the HIC at the time the invoice or receipt is generated. In this mode, the Internet connection must be available when the invoice or receipt is created. This removes the need for batching up claims at the end of the day, however it will slow down the invoicing and receipting process while the transmissions are performed. For this reason, a broadband Internet connection is strongly recommended for sites wishing to do Real-Time Patient Claims.

Enabling Patient Claims

Before you can use Patient claims you must enable it in your Practice Preferences. Choose Practice Preferences from the File menu and double-click your practice name in the list to open it. Go to the Miscellaneous tab and ensure that Use Patient Claims is ticked in the HIC Online area. If you will normally be performing Real-Time Patient Claims, tick the Run Real-Time by Default checkbox.